The effect of problem-based learning on students’ approaches to learning in the context of clinical nursing education

doi:10.1016/j.nedt.2005.12.001

Nurse Education Today

Volume 26, Issue 5, July 2006, Pages 430-438

https://doi.org/10.1016/j.nedt.2005.12.001 Get rights and content

Summary

The effect of problem-based learning (PBL) on nursing students’ approaches to learning has received scanty attention in nursing education. The purpose of the present study was to evaluate the effect of PBL on students’ approaches to learning in clinical nursing education. Using a one-group before–after quasi-experimental design, the revised two-factor Study Process Questionnaire (R-SPQ-2F) was administered to compare students’ approaches to learning before and after a period of clinical education in which PBL was implemented. Focus group interviews were used to elicit from students their PBL experience. Of the 237 students who participated in the study, 187 returned the R-SPQ-2F, representing a response rate of 78.9%. Twenty-eight of the students also participated in focus group interviews. The R-SPQ-2F scores indicated that for the deep approach to learning, the post-test mean score was noticeably higher than that at the pre-test (p = 0.005). No significant difference was observed between the pre-test and post-test mean scores for the surface approach to learning (p ⩾ 0.05). The four themes inductively derived from students’ descriptions of their clinical education experience (motivated to learn; self-direction in learning; active, interactive and student-centred learning; and enjoyment in learning) also suggested that the students adopted a deep approach to learning during a period of clinical education in which PBL was implemented.

Introduction

Nursing is essentially a practice discipline (Johnson, 1999) and an important goal of nursing education is to facilitate the transition of theoretical knowledge to clinical practice (Bowers and McCarthy, 1993). Clinical education is a crucial link between university education and professional practice which offers an opportunity for nursing students to apply knowledge acquired at university into the practice setting (Williams, 1999). Properly designed and implemented, clinical education should enable students to develop and attain competence in a real-life situation (Biggs, 2003). However, the clinical context is also flawed with difficulties (Morton-Cooper and Palmer, 2000) for both nursing students (Kleehammer et al., 1990, Young, 1996) and clinical educators (Edmond, 2001, Stamnes et al., 1998). Furthermore, the contextual factor may impact on student learning in a way not intended originally. Such a contextual effect was clearly demonstrated in an earlier study by this team of researchers in which nursing students adopted a surface approach to learning during a period of clinical education in response to a heavy learning workload, insufficient time for learning and high anxiety (Tiwari et al., 2005). Alarmed by the students’ inappropriate approaches to learning and negative responses to what should have been a stimulating and exciting learning opportunity, the researchers subsequently implemented problem-based learning (PBL) in clinical education. Our intention was to create a learning context which would enable students to engage in deep, meaningful learning through solving real-life problems (Biggs, 2003). Previous studies have shown that students adopted a deep approach as a result of undergoing PBL (Newble and Clarke, 1986, McKay and Kember, 1997). The present study sought to evaluate the effect of PBL on nursing students’ approaches to learning.

Section snippets

Literature

PBL, described as the ‘most significant innovation in education for professions for many years’ (Boud and Feletti, 1997, p. 1) has gained wide acceptance in medical, nursing and paramedical education (Milligan, 1999). While several meta-analyses of evaluative research have been conducted for PBL in medical education (Albanese and Mitchell, 1993, Vernon and Blake, 1993, Newman et al., 2003), most of the nursing literature has focused on the descriptive and prescriptive accounts of implementing

Study design

We used a one-group before–after quasi-experimental design (Cook and Campbell, 1979) to evaluate the effect of PBL on nursing students’ approaches to learning.

Participants

All 237 undergraduate nursing students who received PBL during their clinical education between January and August 2004 at a university in Hong Kong were invited to participate in the present study. A breakdown of the student groups by year of study and period of clinical education is shown in Table 1. The students were assured that their

Results and discussion

Of the 237 students who received PBL during clinical education, 187 returned the R-SPQ-2F at pre-test and post-test, representing a response rate of 78.9%. A breakdown of the response rate by year of study is shown in Table 2. The demographic characteristics of the students, who are Chinese, born and bred in Hong Kong, are shown in Table 3.

Conclusion

The purpose of this study was to investigate the effect of PBL on nursing students’ approaches to learning during a period of clinical education. The quantitative data showed that students had made worthwhile improvement in the deep approach to learning. This was confirmed by students’ descriptions of their PBL experience which revealed characteristics of deep learning. The results of this study provide empirical support for the suggestion that PBL promotes a deep approach to learning (Biggs,

Acknowledgements

The study was supported by the Leung Kau Kui and Run Run Shaw Research and Teaching Endowment Funds of the University of Hong Kong.

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The effect of problem-based learning on students’ approaches to learning in the context of clinical nursing education

Summary

Introduction

Section snippets

Literature

Study design

Participants

Results and discussion

Conclusion

Acknowledgements

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Nurse Education Today

Problem-based learning: a review of literature on its outcomes and implementation issues

Academic Medicine

Teaching tools problem-based learning

Nurse Educator

A taxonomy of problem-based learning methods

Medical Education

An evaluation of problem-based learning in a nursing theory and practice module

Nurse Education in Practice

Teaching for Quality Learning at University

The revised two-factor study process questionnaire: R-SPQ-2F

British Journal of Educational Psychology

The Buck stops here: accepting responsibility for learning and actions after graduation from a problem-based learning nursing education curriculum

Journal of Advanced Nursing

Developing analytical thinking skills in early undergraduate education

Journal of Nursing Education

Quasi-Experimentation: Design and Analysis Issues for Field Settings

The implementation of problem-based learning: changing pedagogy in nurse education

Journal of Advanced Nursing

Overseas students in the United Kingdom university system

Higher Education

Nursing science: basic, applied, or practical? Implications for the art of nursing